Primary Diffuse Large B-cell Lymphoma of the Breast: Treatment and Long-Term Outcome of Two Cases

Rajesh Kashyap; Pradeep Kumar; Hira Lal; Ram Naval Rao

doi:10.4103/ijmpo.ijmpo_4_18

Indian Journal of Medical and Paediatric Oncology, Table of Contents

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(01): 78-81
DOI: 10.4103/ijmpo.ijmpo_4_18

Practitioner Section

Primary Diffuse Large B-cell Lymphoma of the Breast: Treatment and Long-Term Outcome of Two Cases

Rajesh Kashyap

Department of Hematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

,

Pradeep Kumar

Department of Hematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

,

Hira Lal

Department of Radio Diagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

,

Ram Naval Rao

Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

› Author Affiliations

Abstract

Primary breast lymphoma (PBL) is a rare form of extranodal non-Hodgkin’s lymphoma (NHL). It accounts for <0.5% of all breast malignancies and 2% extranodal NHL. Diffuse large B-cell lymphoma (DLBCL) is the most common histological subtype. We report three cases of PBL diagnosed and treated at our center. The clinical records of three female patients diagnosed with PBL from 2004 to 2015 were reviewed. Two patients had DLBCL, and the third patient had anaplastic large cell (ALCL) NHL. The mean age at presentation was 56 years. One patient with DLBCL was treated with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy and the second patient with rituximab plus CHOP chemotherapy. Both the patients showed complete response and have had a disease-free survival of 84 and 96 months, respectively. The third patient with ALCL refused further treatment after confirmation of diagnosis. PBL-DLBCL can be successful treated with chemotherapy, and long-term survival is similar to nodal NHL.

Keywords

Breast lymphoma - chemotherapy - diffuse large b-cell lymphoma - rituximab

Full Text

References

References
1 Kim SH, Ezekiel MP, Kim RY. Primary lymphoma of the breast: Breast mass as an initial symptom. Am J Clin Oncol 1999; 22: 381-3
2 Shapiro CM, Mansur D. Bilateral primary breast lymphoma. Am J Clin Oncol 2001; 24: 85-6
3 Dao AH, Adkins Jr. RB, Glick AD. Malignant lymphoma of the breast: A review of 13 cases. Am Surg 1992; 58: 792-6
4 Zack JR, Trevisan SG, Gupta M. Primary breast lymphoma originating in a benign intramammary lymph node. AJR Am J Roentgenol 2001; 177: 177-8
5 Wiseman C, Liao KT. Primary lymphoma of the breast. Cancer 1972; 29: 1705-12
6 Cheah CY, Campbell BA, Seymour JF. Primary breast lymphoma. Cancer Treat Rev 2014; 40: 900-8
7 Tavassoli FA, Devilee P. WHO Classification of Tumors: Pathological Genetics of Tumors of the Breast and Female Genital Organs. Lyon: IARC Press; 2003
8 Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the committee on Hodgkin’s disease staging classification. Cancer Res 1971; 31: 1860-1
9 Jeanneret-Sozzi W, Taghian A, Epelbaum R, Poortmans P, Zwahlen D, Amsler B. et al. Primary breast lymphoma: Patient profile, outcome and prognostic factors. A Multicentre Rare Cancer Network study. BMC Cancer 2008; 8: 86
10 Wong WW, Schild SE, Halyard MY, Schomberg PJ. Primary non-Hodgkin lymphoma of the breast: The mayo clinic experience. J Surg Oncol 2002; 80: 19-25
11 Ganjoo K, Advani R, Mariappan MR, McMillan A, Horning S. Non-Hodgkin lymphoma of the breast. Cancer 2007; 110: 25-30
12 Jennings WC, Baker RS, Murray SS, Howard CA, Parker DE, Peabody LF. et al. Primary breast lymphoma: The role of mastectomy and the importance of lymph node status. Ann Surg 2007; 245: 784-9
13 Lyou CY, Yang SK, Choe DH, Lee BH, Kim KH. Mammographic and sonographic findings of primary breast lymphoma. Clin Imaging 2007; 31: 234-8
14 Ryan G, Martinelli G, Kuper-Hommel M, Tsang R, Pruneri G, Yuen K. et al. Primary diffuse large B-cell lymphoma of the breast: Prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group. Ann Oncol 2008; 19: 233-41
15 Avilés A, Delgado S, Nambo MJ, Neri N, Murillo E, Cleto S. et al. Primary breast lymphoma: Results of a controlled clinical trial. Oncology 2005; 69: 256-60
16 Avilés A, Castañeda C, Neri N, Cleto S, Nambo MJ. Rituximab and dose dense chemotherapy in primary breast lymphoma. Haematologica 2007; 92: 1147-8
17 Sun Y, Joks M, Xu LM, Chen XL, Qian D, You JQ. et al. Diffuse large B-cell lymphoma of the breast: Prognostic factors and treatment outcomes. Onco Targets Ther 2016; 9: 2069-80
18 Yhim HY, Kim JS, Kang HJ, Kim SJ, Kim WS, Choi CW. et al. Matched pair analysis comparing the outcomes of primary breast and nodal diffuse B-cell lymphoma in patients treated with rituximab plus chemotherapy. Int J Cancer 2012; 131: 235-43
19 Villa D, Connors JM, Shenkier TN, Gascoyne RD, Sehn LH, Savage KJ. et al. Incidence and risk factors for central nervous system relapse in patients with diffuse large B-cell lymphoma: The impact of the addition of rituximab to CHOP chemotherapy. Ann Oncol 2010; 21: 1046-52
20 Ou CW, Shih LY, Wang PN, Chang H, Kuo MC, Tang TC. et al. Primary breast lymphoma: A single-institute experience in Taiwan. Biomed J 2014; 37: 321-5